University Occupational Health Services | The University of Tennessee Graduate School of Medicine, Knoxville (2024)

University Occupational Health Services and UT Travel and Immunization Clinic

Overview

University Occupational Health Services is committed to managing the full range of services needed to safely place workers, maintain the health and productivity of the workforce, and restore injured employees to health as quickly and cost effectively as possible. This is achieved by developing a personalized program that may consist of pre-placement physical exams, return-to-work exams, work-related injury treatment, drug screens, breath alcohol testing, medical surveillance, FAA pilot medical exams, and other medical services specific to industry.

The medical staff, consisting of M. David Stockton, MD, MPH, Gregory Blake, MD, MPH, Jon Parham, DO, and Donald S. Keeble, MD, is committed to providing the best medical care for employees, while insuring compliance with the legal and regulatory issues involved in occupational medicine. The medical and legal needs of the three customers are recognized: the patient, the employer and the worker's compensation insurance carrier. Service effectiveness is based on timely communication with the employer and appropriate use of supporting services.

Occupational medicine services are offered at the University of Tennessee Medical Center location Monday through Friday, from 8:00am to 5:00pm. Though appointments are requested for pre-placement and periodic screening, medical care is offered for client companies on a walk-in basis for injuries and accidents. Complete diagnostic screening and x-ray capabilities allow efficient delivery of services. Equipment and services available at the clinic include full provision for physical examinations, vision testing, audiometry, pulmonary function testing, x-ray, electrocardiogram, breath alcohol testing, drug screen collections and MRO services for non-DOT and DOT, and a variety of laboratory studies.

FAA exams can be scheduled with ease because there are three Aviation Medical Examiners on staff. Drs. Stockton, Blake, and Keeble are FAA certified to perform Class I, II and III pilot exams.

The Emergency Department at The University of Tennessee Medical Center provides after hours emergency care with drug screen collections. Tennessee Drug and Alcohol Consortium (TDAC) provides after hours drug screen collections and breath alcohol testing. These services must be arranged with them. University Occupational Health Services is not contracted with them for after-hours coverage, nor are they an extension of this program. Work-related injuries and drug screening results can be referred back to this clinic for follow-up care when the employee or employer lists one of the physicians located at this facility as his or her occupational medicine provider, or Medical Review Officer (MRO).

UT Travel and Immunization Clinic

The University Occupational Health Services now offers immunizations for travelers as recommended by The Centers for Disease Control (CDC).

Our services include:

• Pre-travel consultation and counseling including access to real-time information regarding health, social, and political situations around the world.
• Individualized travel immunization and protective medications
• Country-specific handouts and health safety travel information
• Counseling for travelers with current medical problems
• Material providing information such as travel related illnesses e.g. malaria, diarrheal disease, etc.
• Destination-specific risk information

The following immunizations are conveniently offered in the office located on The University of Tennessee Medical Center Campus:

• Yellow Fever
• Typhoid
• Meningococcus
• Hepatitis A
• Hepatitis B
• Tetanus/Diphtheria/Pertussis
• Mumps/Measles/Rubella
• Rabies
• Varicella (Chickenpox)
• Pneumovax
• Japanese Encephalitis

Planning a trip?

Please note immunizations require 4-6 weeks for full effectiveness. We recommend scheduling your office consultation at least 2 months prior to travel.Bring your prior immunization record to the visit. To make an appointment, please call 865-305-8831.

Physical Examinations (Pre-Placement and Regulatory)

Many companies require a physical examination after a conditional offer of employment has been made. Pre-placement physical examinations are determined by job requirements. Components may be included to document baseline information, to meet regulatory requirements (eg. Respirator wear and DOT), and to determine the individual's ability to safely perform the essential functions of the job. Accurate job related information including physical demands allows the physician to make knowledgeable recommendations.

Other physical examinations are developed to handle post-employment and ongoing regulatory requirements. A comprehensive examination program to promote the continued good health of the work force is also an option.

Here are examples of two commonly used physicals:

Non-Arduous Position (Clerical, Sales, etc.)

• Medical History
• Vital Signs
• Physician Exam
• Dipstick Urinalysis
• Vision - Snellen

Arduous Position with Respirator Wear - Basic Exam

• Medical History
• Vital Signs
• Physician Exam
• Dipstick Urinalysis
• Vision - Titmus
• Range of Motion
• Pulmonary Function
• Audiometry

Other components may include lab tests as well as x-rays.

Executive Physical Examinations

Executive physicals are an excellent benefit for your key employees and a valuable investment by your company. The usual procedure involves an initial visit to collect lab specimens and complete paperwork. The second visit is scheduled one to two weeks later and includes the actual physical. Immediately after the exam, the patient meets with the physician and reviews all exam and test results in a comprehensive interview session. A single session appointment can be arranged but test results will not be available to maximize the value of the physician interview. The following is a basic suggested exam plus many additional options that could be included at varying frequencies.

Suggested Executive Physical

• Detailed Medical History
• Vital Signs Comprehensive
• Physical Examination
• Body Composition Analysis
• Pulmonary Function
• Audiometry
• Vision Screen
• Urinalysis
• Complete Blood Count
• Comprehensive Metabolic Panel
• Cardiac Lipid Profile

Optional Components

• Occult Blood/Colon Cancer Screen (Age 50, then annually)
• Resting EKG (Baseline, then as indicated)
• Chest X-Ray (Age 35 then as indicated)
• Prostate Cancer Screen ( Age 50, then annually)
• Pap Smear (Annually) Treadmill (Age 50, then as indicated)
• *Mammogram (Age 40, then every 1-2 years)
• *Stress EKG (Age 50, then as indicated)
• *Colonoscopy (Age 50, then every 5 years)

* The staff can arrange these tests; however billing will be done by the testing provider or facility according to its fee schedule and billing policies unless prior arrangements have been made through the facility at University Occupational Health Services.

Vaccinations and Health Screens Related to Employment

Some jobs involve potential exposure to blood borne pathogens. Other jobs may fall under State Department of Health guidelines. Vaccination or documentation of existing immunity may be required as part of your placement process. The following services are offered at the University Occupational Health Services clinic.

Hepatitis B Vaccine

This vaccine must be offered to all employees with potential exposure to blood or blood- borne pathogens. A series of three injections over 6 months is required. Patients are advised in writing of the vaccination schedule at the time of their first injection.

Mantoux TB Test

This vaccination is necessary for most healthcare and child care workers.

Diphtheria, Tetanus, Acellular Pertussis (Dtap) Booster

Indicated every 5-10 years for workers with potential for puncture wounds

Hepatitis B Surface Antibody

Determines immunity for employees who have previously completed a vaccine Series or who may have had Hepatitis B

Hepatitis B Surface Antigen

Determines if the individual is a carrier of Hepatitis B

Other vaccines and/or screens are available for Hepatitis A and C, Measles, Mumps, Rubella, and Chicken Pox as well as other industrial screens such as heavy metals, etc.

Respirator Evaluation

Based on the 1998 Final Rule of the IOSHA and OSHA Respiratory Protection Standard, a medical surveillance program is necessary for all individuals required to wear respirators including paper dust masks. This program offers two levels of service.

Paper Dust Mask

If the only respirator protection used is a paper dust mask for nuisance dust, each affected employee must complete a six-page medical history that meets the OSHA Respiratory Protection Standard. Physicians will review the history. If no medical conditions are indicated, a physician statement approving the use of the paper-dust mask will be completed.

All Other Masks and All Individuals with Medical Conditions

If the medical history indicates that further medical review is needed or if a respirator other than a paper dust mask is used, the following respirator evaluation is recommended for clients. This evaluation is based on the medical evaluation program suggested within the OSHA standard on respiratory protection.

Physical Examination for Respirator Evaluation - Baseline & Periodic

1. Medical History specific to Respiratory Evaluation
2. Review Information on Specific Respirator Being Used
3. Physical Examination
4. Pulmonary Function Testing
5. Snellen Vision
6. Dipstick Urinalysis

May be Required when indicated by medical history or physician exam

1. EKG- Resting 12 lead
2. Chest X-ray PA

Protocol for Medical Evaluation of Employees Required to Use Respiratory Protection

• Purpose of Respirator Medical Evaluations
  1. Persons assigned to jobs that require the use of respiratory protection (dust mask, half or full face, SCBA) must be evaluated to determine if they are physically able to perform the work and use the equipment.
  2. All persons required to wear respirators, including dust masks, must be medically cleared prior to assignment in a job that requires respirator use, and periodically thereafter.
• The frequency of these examinations will vary depending upon several factors:
  1. Type of respirator
  2. Use of respirator
  3. Age of employee
  4. Health of employee

Workers' Compensation Injury Treatment

Occupational Health Services provides work-related injury treatment on a timely basis. Treatment is given for musculoskeletal injuries (sprains, strains, and simple fractures), lacerations, foreign bodies in the eye, and similar cases where the skills of other specialists are not required. Injuries that are more complex are assessed, stabilized and referred as appropriate. Emergency Departments provide care for traumatic injuries. The general policy on all injuries is to report restrictions to the employee's management so they can determine the appropriate accommodations.

Standard forms include an authorization form and a treatment information form, which is given to the employee at time of service and mailed to the company contact within 48 hours.

This team supports aggressive management of injuries while keeping quality care as the primary concern. Timely services and communication reduce loss time. With the employee's (or employer's) approval, referrals to other specialists or appropriate rehabilitation programs are made when indicated. Charges for treatment are determined by the nature of the injury and are competitive with area providers.

Specialist Referral

Company preferences on specialists will be honored. If there are no preferred specialists listed on the client summary profile, the physicians will utilize the specialists they are most familiar with, making sure that these specialists not only support releasing patients for restricted work duty, but that these specialists promise timely communication so that appropriate coordination of services may be achieved.

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